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REV-16-1023 Afir.0N2016 09:52 PM MENESES & ASSOCIATES GROU 3056383523 PAGE. 1/ 1 CERTIFICATE OF LIABILITY INSURANCE DA 04-05-2016 rr) THIS CERTiFiCATE IS ISSUED AS A MATTER QF INFORMATION ONLY AND CONFER$NO RlGHT3 UPQN THE CERTIFICATE FfOLDEIt.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder in an ADDITIONAL INSURED,the p ollc (its must Do indorsed. IfSUSR0GAVON.IS.WAIVED,_iu act to the terms and condltlons of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Iltu of such endorsement(s), PRODUCER - CA MEE:_ Marcos Alvarez --_--__— ------.---- _ NA _______ _ _______ _•� Excellence Insurance Agency PHONE (305)228 3aoD - - �It.FId1: ,2. 5-) _.____ l IANC•Nor. (305)226.3997 3601 SW 107 Avenue MAlvare2qExcellencelnsurance.net Miami,FL 33155 INBURERl91AFFORDINGtOVERAGE NANCN i'hone 305 22r3 3900 Fax 305 226.3997 INSURER A: Grarrida Insurance Company16670 ENSURED INSURER B! A65oc)ated Indus(riee In6UMnCe COmpany GALAN ELECTRIC CO. INSURER c_- _-- ---r- — 3192 NW 45 St Miami,FL 33142 305, wuRrR :_ _ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: Th11S IS TO-CERTIFY'f1.1AT TFI[POUCIES•Of INSURANCE LIS7E0 BELOW HAVE E1EEN ISSUED TO THE INSURED NAMED A64VF FOR THE POLICY PERIOD I INDICATED. NOTWITHSTANDING ANY REOUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT*WITH RESPECT TO WHICH THIS CEMTIPICATE MAY SE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 16 SUBJECT TO ALL THE TERMS, 1_._EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAWS. INSR 1 TYPE OF INSURANCE 1ADDLPUBRI P pOLjCY AFF_ 1_LTR..........._..-...-- OLIf:VNVMBER.. ... . (MMIIISD .Iv . 11(MptlpplYYVY) LIMITS _....- .._._.I_�_.._..__... -......-._...-.... GENERAL UAINIUTY I ( I 1 EACH OCCURRENCE a 1,00_0.000.0.0__ I ! -U4(�1AGE1'O-REIV�LD - V COMMERCIAL GENERAL LIABILITY i 1 OO,000.00 L� I .P.flkN!l�fi.lEe.aos,Kter..eej....'.._ ... ....._ CLAIMS-MAnE �/ OCCUR I• MED F.XP(Any one person) = 5,000.00 A 0186FL00062566-0 09/08/2015.09/08/2018 1�f PD$500 Deductible I Y N 1 _.........._. . .. .. ........ ......... ... . . ....... 1,1100,000.00 ••� GENERAL AGGREGATE_ j 2,000,00_0.00 _ j or�rwi.AGOREOrATE LIMB APPLIES PER: I I PRODUCTS.COMP/OPAGG S 2.000,000.00 I3 PRO. 17 !J POl ICV JFCT loc. I _......_........ I AUTOMOBII.F.LIABILITY ���pMBIN'.fIINGLE UPAIT (EB dCc1 .........._.........._. i 1 I ANY AUTO ! BODILY INJURY(Par parson) S ALL OWNED �...� I I _._.,.-.-.. AUTOS AUTOS BODILY INJURY(Per wzid.a-n- -$ �- VNO 3MIREO AUTOS AUTOS �l� . - -_--- ---_------..--_-_.__--.-...-_--..--•-- — I , s UMBRELLA 11AB fLr-J1 OCCUR i EACH OCCURRENCE •• -�•--""_..._..__._-._._. - ...FXCESSLIABCLAIM3:NIADF_- ..,�._.....• ..... • I ! AGGREGATE 3 (..� OED REIENI'ION j_.....__....... .. ........_._..l .. ...-.._.- ...._..-.__......__._...---� WOR KERS COMPENSATION VICSTATU- I OTH- AND EMPLOYERS'UABIL(TY Y/N 11'QItX.LU�IITS.,.....•I.ER......e... ANY PROPRIETOR/PARTNERIEXECUTIVF, jAWC1058545 E L EAIOFFICE"EMBER EXCLUDED? Y- 02/24/2016 02124/2017;E.L.- - -1.00,0.00.00._ ........ (Mandatory In NN) I l I F_A DISEASE-FA EMPLOYE S 100 000.00 If as,describe under -•-- DESCRIPTION OF OPERATIONS Oelow [.L,DI9GA9lc•POLICY LIMA• 8 500,000.00 i � 1 � i DESCRIPTION OF OPERATION51 LOCATIONS /"VEHICLES*(Attach ACORD 101,Addlllonal Remarks Schedule,It mare space is requlrsd) � ' L��- . 1 I I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF TH ABOV SCRIBED POLICIES BE CANCELLED BEFORE MIAMI SNORES VILLAGE THE EXPIRATION E T EOF,NOTICE WILL SE DELIVERED IN ` 10020 NE 2N0 AVE ACCORDANCE T To PROVISIONS. MIAMI SHORES,FL 33138 .. ._.-._—....___-. —_._._..... ............. —.-.-...I I 305-795.2207 AUTHORIZED REP � ATNE � ' I m -2i4 ACORD CORPORATION. All rights reserved. ACORD 25(2010!05)QF The ACORD name and logo are registered marks of ACORD I t Miami Shores Village _- Building Department APR 112018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 $Y; Tel:(305)795-2204 Fax:(305)756-8972- INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2011-t ' BUILDING Master Permit No. - • PERMIT APPLICATION . Sub Permit No. 1"' gV I ^ Io23 ❑BUILDING ELECTRIC ❑ ROOFINGN EXTENSION [:]RENEWAL F_] ❑ MECHANICAL ❑PUBLIC WORKS E Joni 'V�'S CCrGS JOB ADDRESS:_ .\o 'Aj W ,o&-d ' City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: r/ Flood Zone: BFE: FFE: OWNER: Name(Fee Simple�Titlehh Ider): A4I Phone#:y Address: City: N.1* j State: Zip: Tenant/Lessee Name: Phone#: Email: //�� r CONTRACTOR:Company Name: 6A LA N 6LCC7W C C•.� Phone#: Address: ? 45154 T City: PFS + ( / State: 11L Zip: 5114- i 7 Qualifier Name: /votz (! • l�q(5fa/ 4 Phone#:" 351-4-25f State Certification or Registration#: ac uon 5 Certificate of Competency#: DESIGNER:Architect/Engineer: l9 Phone#: Address: City: State: Zip: +� Value of Work for this Permit:$✓ Square/Linear Footage of Work: 1N V' t _ Type of Work: ❑ Addition Iteration ENew ❑ Repair/ epla e D molition Description of Work: k t - Specify color of color th'ru tile: > F?i Submittal Fee$ • Permit Fee$ /S 4''4O CCF$ ( , CO/CC$ Scanning Fee$ Radon Fee$ 2• 2-1 DBPIR+$ Notary$ Technology Fee$ ' ' Training/Education Fee$ Q . �(d Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1 (S Q (Revised02/24/2014) r� i Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in.this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS,.TANKS,AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating'construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatur Signature OWN or AGENT CONTRACTOR The foregoing instrument wasacknowledgedbefore me this The foregoing instrument was acknowledged before me this Zq day of 0 0-K C /1 120 I �o by day of /►��1 GZ+"G� 20 by who is personally known to ©hJQ V` rSO(CR r) . ,who is personally known to me or who has produced as me or who has produced bn t1Pty, as IP 40D bsa- ?a_ 4159. identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARYPUBLIC: Sign: Sign: __:L 1 Print: 1 /�V- ICV Print: Seal: Y er SUNEN COLLAZO Seal: X10MARq A lAU R MY COMMISSION#EE 874940 MY COMMISSION#FF,^ ' ' EXPIRES:Apol 14,2017 y° 'd: r'a; cLy19 ti EXPIRES Jz;ivary i �ciq ti, 11.;at' BondedThruNoWNPublicUnderwdtera APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) AAA(, P ■wry- �y pqp� 1�� �j �J ice/ tJ alt �1 n-s ����Jlhk N. r .8. sheet I of 2 ,0 � ` 7AC7G "�W 9th Street Northea109t Street A '" A65 214 Q9 10 11 12 13 14 15 16 9 14 15,0000 >Q5 . . .. . rt. T� Northwest 108th Street Northeast 108th'S19ftt r"'z 6666.. w. z 6666 6666 Z:09 6666 6669 .0000 8 7 6 5 2 1 4 3 2 1 8 7 6 5 210 4...3. 2.. 1 00:00' 0 0 . .. .. . .. 6666.. :;rzf�- . 0 . . 6000.0 0 6666.. . 6666.. 00 0 66.6 0 0 0 PROPERTYADDRESS: ABBREVIATIONS ELE VA TION INFORMA TION A E. -AVENUE-ARC DISTANCE National Flood Insurance Program ' E.. AV 13 Northwest 108th Street ASPH-ASPHALT A/C -IR BUILDING OVER FEMA Elev. Reference to NGVD 1929 BCR.-BLOCKCORNER g Miami Shores Florida 33168 BLDG.. -BLOCC1 C.B.O-CATCN BASIN Comm Panel 120652 CLF -CHAIN LINK FENCE CONC.-CONCRETE. COL. -COLUMN SURVEYOR NOTES. C.U.P.-CONCRETE UTILITY POLE Panel # ��302 C.L.P.-CONCRCONCRETE LIGHT POLE Firm Zone: .0 X �-, #1 Lands Shown Hereon were not abstracted for Cas -CONCRETE BLOCK STRUCTURE Easement and/or Right of Way Records.The C.M.E.-CANAL ENT�Ii-NANCE �� I Easement/Right of Way that are shown on EASEMENT Date of Firm: en 09-11=2009 survey are as per plat of record unless otherwise noted. nnv-oelvnEwnY �1J I 1 #2 Benchmark:Miami-Dade County Public Works Dep. D.M.E.-DRAINAGE&MAINTENANCE Base Flood Elev. �V�A B.M.#N-566,Elevation=10.78' ENC.-ENCROACHMENT F.Floor Elev. 11':97' #3 Bearings as Shown hereon are Based upon E.T.P.-ELECTRIC OWERTRANAND LIG PAD F.P.L.-FLORIDA POWER AND LIGHT Northwest 108th Court,N89055'35"W F.H.-FIRE HYDRANT Garage Elev. TT #4 Please See Abbreviations RLP.-FOUND IRON PIPE P.F. -FINI.-FO ND OORDRILL Suffix: "L"I rl' v #$ Survey is incomplete Without Sheet 2 oft P.D.H.-POUNDEBAR HOLE #6 Drawn B M.Pio;A.Torres Date:06-28-15;7-29-16 F.R. rOUND ISC By: F/D -FOUND DISC Elev. Reference to NGVD 1929; #7 Complete Field Survey Date:06-24-15;7-29-16 E/N -FOUND NAIL 48 Disc No 2016,Station Surveying Scion I/ -LENGTH-IRON FENCE 49 Last Revised: L.P. -LIGHTPOLE #10 Legal Description Furnished b client. M HA-MAN HOLED 8 p y N.G.V: NATIONAL GEODETIC CER TIFIED ONL Y TO.- #11 This Certification is only for the lands as described. VERTICAL DATUM It is not a certification of Title,Zoning,Easements, N.T.S.-NOT TO SCALE. or Freedom of Encumbrances.ABSTRACT NOT O.E. -OVERHEAD ELECTRIC LINE. Mello Holdings O/L -ON LINE REVIEWED. P.C.P.-PERMANENT CONTROL POINT #12 There may be additional Restrictions not shown on P.C. -POINT OF CURVATURE this surveythat may be found in the Public Records R -RADIUS y RF:S -RESIDENCE of Miami-Dade County,examination of ABSTRACT SDWLK-SIDEWALK T -TANGENT LEGAL DESCRIPTION: OF TITLE will have to be made to determine record U.F. -UTILrIY EASEMENT instruments,if any affecting this property. W P WOOD FENCE AL Lot 15, Block 214, of: "DUNNINGS MIAMI .V. W -WATER N #13 ACCURACY:The expected use of the land,as classified W.U.P =WOOD UTILITY POLF in the Minimum Technical Standard 5J-17.050,Is -IRON FENCE > �--�� -CRAM LINK FENCE SHORES EXTENSION NO. 7" according to the "Residential".The Minimum relative distance accuracy - -WOOD FENCE plat Thereof as Recorded in Plat Book 52 Pa for this type of boundary survey is I foot in 10,000 feet. -CBs-OVERHEAWALL ELEC. e g D Theaccuracy obtained by measurement and calculation — -CENTER LINE 33 of the Public Records of Miami-Dade of a closed eometric fi ure was found to exceed this -EASEMENT g g �� -DENOTES ELEVATIONS }�� requirement. —♦ -D BUILDING County, Florida. NCE #14 Foundations and/or footings that may cross beyond the ~® =CATCH BASIN boundary lines of the parcel herein described are not ® =WATER METER shown hereon. ° =W.U.P. #15 Not Valid without one si ature and the oriinal raised -STATE ROAD � g � =US HIGHWAY seal of a Florida Licensed Surveyor and Mapper. (D -INTERSTATE Additions or deletions to Survey maps or reports by g -MONITORY WELL other than the signing party or parties is prohibited without written consent of the signing patty or parties. This certifies that the survey of the property #16 Contact the appropriate authority prior to any design work on information. described hereon was made under my super- work & Vision&that the survey meets the minimum #17 Underground utilities are not depicted hereon,contact technical standards set forth by the Florida the appropriate authority prior to any design work or Board of Professional Land Surveyors& construction on the property herein described. Mappers in Chapter$J-17.050 of Florida Surveyor shall be notified as to any deviation from CoIII flII IIIC. P Y� Administrative Code,pursuant to Section utilities shown hereon. 472.027,Florida Statutes. #18 Ownership Subject to OPINION OF TITLE. � a &That the Sketch hereon is a true and AS accurate representation thereof to the best v of my knowledge and Belief,subject to notes �pS and notations shown hereon. Lina JOB # 16-704 Professional land Surveyors and Mappers LB#7498 m do F.Alv DATE 07-29-2016 13050 S.W. 133rd Court,Miami,Florida 33186 ,11e ,,;Surveyor apper#5516 PB 52-33 Email: afaco@bellsouth.net State Of riga Ph.: 305-234-0588,Fax: 206-495-0778 Not Valid unless Signed& tamped with Embossed Seat 9 ul py 8 ugg-mv:/ey d-.1 -a-, sheet Lot 3,Block 214Lot 2,Block 214 Lot 1,Block 214 — — — — — — — — — — — — — — — — - - . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 15.00;'Dedicated'Alley As Per Plat Book 52-33'Miami-'Dadi-Co. 10'Apshalt Pavement ' . . . . . . . . ..Y2 FIP ..... . . . . . . . . . . . . . . . . . . . . Y-. 2 FIP . . . . . . . . . No Id W.U.P. 48'E'.75.00 No Id . . . . . . . . . 0.13' 'AF 0.ro 1.40' T 85' W/F -37 - CBS Wall High 6' H19 'R 6'High i X_x Conc. Shed 6.5'X6' + W/F C.LF. 6'HighHigh 21.80' CBS Wall **too 6'FLUh ***so 0 : Z • Pool 00 • 0 0 00000 so o• *090:ti 0 18.15' + Y 0 0 0 q 10.26' + **:so 10 K 23.00 Lot 14, :Block14 011 Planter. : Block 214 NIZI. 6.40 -Plante. .60' .5. Planter 0.07' so*: 0 2'15.13' • =7 3 0.02- .9' 4S 5.45-�'-+6.80' C.B.S K) —Metal Fence 0 0115'High Wall TWO STORY CBS HOUSE RES.#3747 'S, OD + 0 1,619 sqJt. i 8, A/C �d Slab 1718' a; 3'X3' 0.33' 10.29' 5.1 VOpti — 10 c), Conc. Walk Cq Block )/2'FIP Nod -5 F/N A Corner 7 5'Sidewalk 'o 4.75' 75.W . NWW35 to . . . . . . . . . . . . . . .... I . . . . . . . . . . .g. . . . . . . . .. . Asphalt D/W . . . . . . . . . . . . . . . IQ . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . rJ . . . . 4 23.5'Parkway m . . . . . . . . . . . . . . M . . . . . . . . . . . . . . . . . . . . . Asphalt D/W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17'Apshalt Pavement. . . . . . . ... . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . .I. . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . 114.76' . . . . . . . . . ... . . . . . . . . ... 0 ........._. I z 114.76'' N8755'35'W 16 . . . . . . . . 75.00' - . . . . . . . . . . . . . . . . . . . . . . . . 5)i... � 1 ' �1 . . . . . . . . . . . . . . . . . . . . . . . . . . .7 77-77=.7�77. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..F/N -FtP.. . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Miami Ave. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Northwest 108th Street * . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I. . . . . . . . . . . . . . . . . . . 75.00' Dedicated R/W As Per Plat Book 52-33 Miami-Dade Co. �7 5'Sidewalk JOB # 16-704 DATE 07-29-2016 AFA & The sketch hereon is a true and PB 52-33 CompanyIncAccurate representation thereof to the best , . ofmy knowledge and belief,Subject to notes and Notations shown hereon. Surveyor Notes: goti Survey is Incomplete without sheet I of 2 Scale of Drawing 1"--20' Drawn By.M.Pio;A.Torres Date: 06-28-15;7-29-16 q) Completed Field Survey Date: 06-24-15;7-29-16 44 AFA&COMPANY,INC.LB#7498 a ,F e' 'OF K J #5526 Mapper Professional Land Surveyors and Mappers P 4sil','dSurvey State 13050 SW 133rd CT Miami,Florida 33186 at. Florida PH.305-234-0588 FX.206495-0778 iju Not Valid unless Signed&Stamped with Embossed Seal U,.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL E61iRGENCY MANAGEMENT AGENCY ••• •OMB No. 1660-0008 National Flood Insurance Pro ram " " ' : ;'•' Important: Read the instructions ompages.1•9� • xpiration Date: July 31, 2015 SECTION A-PROPERTY'INFORNI•A'TV ' ' 'F'dR INSURANCE COMPANY USE Al. Building Owner's Name Read Holdings Policy Number: A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Ro:te�n8PtxJ4o; ; ' ; • CQrppany NAIC Number: 13 Northwest 108`"Street • • • • • • • • City Miami Shores State FL 'ZIP Cbde 33168 ••• ••• ' A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) PB 53-23 Lot 15 Block 214 of"Dunnings Miami Shores"Public Rec of Miami Dade Coin WL: ; •'. ;'• ;" ." • ••• A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential; ; • A5. Latitude/Longitude:Lat.25 Deg 52'27.94"N Long.80 Deg 11'54.45"W 00 ' ' Aoriz;41;MO NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 1,601 sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s)within 1.0 foot above adjacent grade 14 within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b 1.246 sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ® Yes ❑ No d) Engineered flood openings? ❑ Yes ® No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State Miami Shores City Of -120652 Miami Dade County Florida B4. Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 12086C-0302 L 09/11/2009 Effective/Revised Date Zone(s) AO,use base flood depth) 09/11/2009 "X" N/A' B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: Bl l. Indicate elevation datum used for BFE in Item 139: ® NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No Designation Date:N/A ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' ® Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters. Benchmark Utilized: N-566 Elev 10.78 Vertical Datum: NGVD 1929 Indicate elevation datum used for the elevations in items a)through h)below. N NGVD 1929 ❑NAVD 1988 ❑Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 10.00 ®feet ❑meters b)Top of the next higher floor 11.97 ®feet ❑meters c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters d)Attached garage(top of slab) N/A. ❑feet ❑meters e) Lowest elevation of machinery or equipment servicing the building 10.36 ®feet ❑meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 10.25 Z feet ❑meters g) Highest adjacent(finished)grade next to building(HAG) 10.35 ®feet ❑meters h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support N/A. ❑feet ❑meters SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a PLACE ® Check here if attachments. licensed land surveyor? E Yes ❑ No SEAL Certifiier's Name Armando F Alvarez 3rd License Number 5526 HERE Title Surveyors&Mappers Company Name AFA&COMPANY, INC Address 13050 Southwest 133`0 Court City MIAMI State FL ZIP Code 33186 Signature Date 06-26-2015 Telephone 305.234.0588 FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions. LLL V f'11 IV19 VLfI III IVM9 L.., F/GIUU L IMPORTA1 T: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O. Route and tScfTci •.0 Po:cy Number: 13 Northwest 108th Street i i City Miami Shores State FL ZIT'Cone 51'68 • Company NAIC Number: SECTION D—SURVEYOR, ENGINEER, OR ARCHITECT CERTIFJCATJON(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance a9enOcq pany,8ndZ3)i0ildtng o;fner; • Comments CROWN OF ROAD +9.79' C.2.e A/C SLAB ELLV 10.36( A/C SLAB•LOC ECOR bF THE RES) A5.)COORDINATES OBTAINED FROM GOOGLE EARTH Signature Date 0x16-2;19 • • • ••• •• SECTION E—BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1—E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C.For Items E1—E4,use natural grade,if available.Check the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown.The local official must certify this information in Section G. SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments. SECTION G—COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8—G10.In Puerto Rico only,enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4—G10)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters Datum G10.Community's design flood elevation: ❑feet ❑meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments. FEMA Form 086-0-33(7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs ••. ;• •; •;• See Instructions for IteSn'At3. IMPORTANT: In these spaces,copy the corresponding information from Section A FaV-INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number: 13 Northwest 108th Street • • • • ' " City Miami Shores State FL • ;IPCcde 33168 • Eompahy NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; `Front View" and "Rear•�iew•�en�l, r�q�irecr `Right Side View" and "Left Side ow View." When applicable, photographs must show the foundation with represgptjti\Pp gxonV%s pf the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this pagt''usJtHb CbntirtuJtioti'PaJ(?. Ri ht Side View Rear View s r Y;ti-f ..:,mss..., /y -r s !s1 Left Side View Front View r 'Y yy � t mR �wY Ri. �yy • ��j1"' �9U t" 'R' iT� } `•Nq�''rt.f�kk �;r.yny. e �-.� �'j� ee FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATI.ON CERTIFICATE, page 4 Building Photograhs .•. ;. •; •;• Continuation Pagr • • • • IMPORTANT: In these spaces,copy the corresponding information from Lecti6lo : FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number: City State ;Igeode* • • .Con- y NAIC Number: If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View'; and, if required, "Right �ipe.V`ew".anq."Le4t, id(� View." When applicable, photographs must show the foundation with representative examples of the flood opki:igt(:r\:--rts,:%s in>9ipated in Section A8. FEMA Form 086-0-33(7/12) Replaces all previous editions.